It is a known problem that patients entering a hospital or other care giving facility are at risk of contracting infections and other diseases that are the result not of the patients' underlying illness, but of the patients' close proximity to and contact with patient care equipment and personnel during treatment. These inflictions, known as nosocomial infections, may have a variety of sources. For example, even though patient care equipment or medicine may be sterile, if the container holding the equipment is not also sterile an infectious agent may be transmitted from the container to the equipment and ultimately to the patient. The Center for Disease Control estimates that 1 in 20 patients (2 million per year) acquire infections in the hospital. It is estimated that nosocomial infections from all microorganisms directly cause 19,000 deaths per year and contribute to 58,000 deaths per year, which makes them the 11th leading cause of death in the US.
Normally, hospitals and other patient care facilities classify nosocomial infection prevention measures into three general categories, based on the nature of the patient care equipment involved. Critical items (such as surgical instruments, catheters and implants) are sterilized, with the objective of destroying all forms of microbial life. Semicritical items (such as fiberoptic endoscopes and endotracheal tubes) often are subjected to a disinfection procedure. Disinfection in this context is intended to destroy vegetative microorganisms, most fungal spores, tubercle bacilii, and small nonlipid viruses. Noncritical items (such as medication carts, bins, bedboards and blood pressure cuffs) receive a simple cleaning which is designed to remove rather than to kill microorganisms.
An underestimated problem with traditional three-tiered prevention measures is the cross-contact between critical, semicritical and noncritical patient care items in the course of treatment. An additional complicating factor is the interaction of patient care personnel with these items in the course of providing treatment to patients. Specifically, the present invention is directed to reducing the risk of nosocomial infection transmission through cross-contact related to the use and care of medication carts.
Commonly, medication carts are comprised of multiple metal or plastic drawers or bins (used as interchangeable terms in this specification) in a mobile cabinet. The drawers are filled with medication in various solid or liquid forms and related patient care equipment. Each medication drawer is designated for the use of a single patient. Ideally, when a patient is released or transferred, or after a predetermined passage of time, that drawer is cleaned and reused for another patient. Presently, however, there are no standards or documented procedures for the cleaning and reusing of medication bins. Bins are frequently reused without the necessary cleaning, in part because a lack of adequate cleaning does not hinder the use of the bin as a container for medication or patient care equipment. In addition, bins are commonly designated to a specific patient by gummed labels that are only partially removable after use. Subsequent labels sometimes fall off and the sticky residue from multiple labels becomes another potential host site for bacteria and pathogens which may be transferred to the medication and then to the patient through repeated contact by the caregiver with the host site in the process of providing curative or palliative care.
It is therefore a problem with conventional medication bins that the bins receive inadequate cleaning and become a site for the transmission of nosocomial infections. What is needed is a way for patient care facilities (or others responsible for the care and maintenance of medication carts) to insure that medication and other patient care equipment is transported to the patient in a medication bin that reliably and repeatedly minimizes the risk of nosocomial infection.